Because people with type 2 diabetes are at an increased risk for cardiovascular disease, there’s a specific concern that the saturated fat in the diet may drive up LDL, or “bad,” cholesterol levels, and further increase the odds of heart problems. If you have type 2 diabetes, talk to your doctor before attempting a ketogenic diet. They may recommend a different weight-loss diet for you, like a reduced-calorie diet, to manage diabetes. Those with epilepsy should also consult their doctor before using this as part of their treatment plan.

Also make sure that you know what foods have mostly carbs, fat, and protein, so you can make the right choices. For instance, it’s not just bread, pasta, chips, cookies, candy, and ice cream that contain carbs. Beans may contain protein, but they’re also very high in carbohydrates. Fruit and veggies also mostly contain carbs. The only foods that don’t contain carbs are meat (protein) and pure fats, like butter and oils (including olive oil and coconut oil).

In 1921, Rollin Turner Woodyatt reviewed the research on diet and diabetes. He reported that three water-soluble compounds, β-hydroxybutyrate, acetoacetate, and acetone (known collectively as ketone bodies), were produced by the liver in otherwise healthy people when they were starved or if they consumed a very low-carbohydrate, high-fat diet.[10] Dr. Russell Morse Wilder, at the Mayo Clinic, built on this research and coined the term "ketogenic diet" to describe a diet that produced a high level of ketone bodies in the blood (ketonemia) through an excess of fat and lack of carbohydrate. Wilder hoped to obtain the benefits of fasting in a dietary therapy that could be maintained indefinitely. His trial on a few epilepsy patients in 1921 was the first use of the ketogenic diet as a treatment for epilepsy.[10]
Stock up: The Amazon Fresh grocery delivery service makes it easy to ensure you always have keto-friendly veggies in the fridge. We love its delivery scheduling tool; simply fill your cart, then decide which day and timeframe you'd like your groceries delivered. One of our faves: Pre-Cut Zucchini Noodles are great for whipping up low-carb "pasta" dishes.

Electrolytes: Due to the increased water expulsion by the kidneys, many electrolytes are simultaneously lost. Electrolyte imbalances are heavily responsible for feeling the “keto-flu.” Important electrolytes one must consider replacing: sodium, potassium, and magnesium. These electrolytes can be replenished by increasing your intake of certain foods and/or supplementation.


So question….what if you are watching your sodium intake due to high blood pressure? From what I read here, there is a lot of salt/sodium involved (more than my normal intake), how do I deal with this issue if doing keto? I do not take any medications. About three years ago I found that my thyroid levels were on the low end of the normal range and it affected my blood pressure. So I lowered my sodium intake and increased my iodine/iodide intake. This has worked for me for the past three years, in the sense that after a month of being on bp meds, I no longer needed those meds and my thyroid levels have stayed around the mid-range of normal. I have always eaten healthy with some junk foods here and there, but apparently being pregnant kicked off a thyroid issue and weight gain. What are my sodium options with keto? How do I balance it so my bp doesn’t take a freefall nor a significant increase?
People use a ketogenic diet most often to lose weight, but it can help manage certain medical conditions, like epilepsy, too. It also may help people with heart disease, certain brain diseases, and even acne, but there needs to be more research in those areas. Talk with your doctor first to find out if it’s safe for you to try a ketogenic diet, especially if you have type 1 diabetes.
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You've likely heard horror stories of what competitors feel like when they cut carbs low, or when the average bro talks about going keto. However, the odds are that those people were not actually in nutritional ketosis, or more importantly, following a well-formulated ketogenic diet. Yes, you may experience some fogginess and discomfort, but it doesn't have to be intense if you handle it right.

Although many hypotheses have been put forward to explain how the ketogenic diet works, it remains a mystery. Disproven hypotheses include systemic acidosis (high levels of acid in the blood), electrolyte changes and hypoglycaemia (low blood glucose).[19] Although many biochemical changes are known to occur in the brain of a patient on the ketogenic diet, it is not known which of these has an anticonvulsant effect. The lack of understanding in this area is similar to the situation with many anticonvulsant drugs.[56]


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Cognitive Enhancement: Ketones may be the preferred fuel source for the brain. Due to the brain’s preference to uptake and utilize ketones as fuel it is very common for individuals to report an increase in cognitive performance. This is even more common in individuals with some degree of insulin resistance, as their brain is likely unable to effectively utilize glucose as a sole fuel source due to the resistance.
Unfortunately, there’s no long-term data on ketogenic diets versus other diets. In a 2015 Italian study, those on a ketosis diet lost 26 pounds in three months. About half of the participants stayed on the diet for a year but lost little additional weight in the next nine months. People in a 2014 Spanish study who followed a very-low-calorie ketogenic diet lost an average of 44 pounds in a year—but a third of them dropped out, possibly because it was too hard to maintain.
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
Children who discontinue the diet after achieving seizure freedom have about a 20% risk of seizures returning. The length of time until recurrence is highly variable, but averages two years. This risk of recurrence compares with 10% for resective surgery (where part of the brain is removed) and 30–50% for anticonvulsant therapy. Of those who have a recurrence, just over half can regain freedom from seizures either with anticonvulsants or by returning to the ketogenic diet. Recurrence is more likely if, despite seizure freedom, an electroencephalogram shows epileptiform spikes, which indicate epileptic activity in the brain but are below the level that will cause a seizure. Recurrence is also likely if an MRI scan shows focal abnormalities (for example, as in children with tuberous sclerosis). Such children may remain on the diet longer than average, and children with tuberous sclerosis who achieve seizure freedom could remain on the ketogenic diet indefinitely.[46]
2) Now you need to do a little learning before we move any further. Start by learning a bit more about ketosis itself, and the pitfalls you may experience. I love Bodybuilding.com and think that this article on the Keto Diet is perfect for beginners, so go check it out. Unless you are planning to start bodybuilding part, 2 of the post will not apply to you. 😉
Refreshing, just plain refreshing. Maybe it’s because I’m a nurse anesthetist and I’m more comfortable reading research or journal articles than opinions, but this is an excellent article! It addresses all the questions ,concerns and misnomer surrounding the KD. It is well written, easy to read and gave me that additional depth of understanding that I was desiring. Thank you, thank you, thank you!

Cruciferous vegetables, also known as brassicas and “cole crops”, such as broccoli, cauliflower, cabbage and Brussels sprouts, are truly a low-carber’s best friend! They are the perfect replacement for starchy ingredients such as potatoes, rice and pasta. You can turn them into everything from mash to pizza crusts – true keto magic! Did we mention that most of them are super cheap, environmentally friendly and packed with nutrients, too?


“The cleaner, the better when it comes to the keto diet,” says Jadin. Focus on “whole” and “unprocessed.” Also, strive for a mix of saturated and unsaturated fats for balance. Note: Tipping the scale toward too much protein is a common pitfall many people make on the keto diet. Mind your protein intake, since too much can kick you out of ketosis, says Jadin.
A study with an intent-to-treat prospective design was published in 1998 by a team from the Johns Hopkins Hospital[20] and followed-up by a report published in 2001.[21] As with most studies of the ketogenic diet, no control group (patients who did not receive the treatment) was used. The study enrolled 150 children. After three months, 83% of them were still on the diet, 26% had experienced a good reduction in seizures, 31% had had an excellent reduction, and 3% were seizure-free.[Note 7] At 12 months, 55% were still on the diet, 23% had a good response, 20% had an excellent response, and 7% were seizure-free. Those who had discontinued the diet by this stage did so because it was ineffective, too restrictive, or due to illness, and most of those who remained were benefiting from it. The percentage of those still on the diet at two, three, and four years was 39%, 20%, and 12%, respectively. During this period, the most common reason for discontinuing the diet was because the children had become seizure-free or significantly better. At four years, 16% of the original 150 children had a good reduction in seizure frequency, 14% had an excellent reduction, and 13% were seizure-free, though these figures include many who were no longer on the diet. Those remaining on the diet after this duration were typically not seizure-free, but had had an excellent response.[21][22]
Bonnie J. Brehm, Randy J. Seeley, Stephen R. Daniels, and David A. D’Alessio, “A Randomized Trial Comparing a Very Low Carbohydrate Diet and a Calorie-Restricted Low Fat Diet on Body Weight and Cardiovascular Risk Factors in Healthy Women,” The Journal of Clinical Endocrinology & Metabolism: Vol 88, No 4; January 14, 2009. http://press.endocrine.org/doi/full/10.1210/jc.2002-021480.
Conklin's fasting therapy was adopted by neurologists in mainstream practice. In 1916, a Dr McMurray wrote to the New York Medical Journal claiming to have successfully treated epilepsy patients with a fast, followed by a starch- and sugar-free diet, since 1912. In 1921, prominent endocrinologist Henry Rawle Geyelin reported his experiences to the American Medical Association convention. He had seen Conklin's success first-hand and had attempted to reproduce the results in 36 of his own patients. He achieved similar results despite having studied the patients for only a short time. Further studies in the 1920s indicated that seizures generally returned after the fast. Charles P. Howland, the parent of one of Conklin's successful patients and a wealthy New York corporate lawyer, gave his brother John Elias Howland a gift of $5,000 to study "the ketosis of starvation". As professor of paediatrics at Johns Hopkins Hospital, John E. Howland used the money to fund research undertaken by neurologist Stanley Cobb and his assistant William G. Lennox.[10]
There are so many tricks, shortcuts, and gimmicks out there on achieving optimal ketosis – I’d suggest you don’t bother with any of that. Optimal ketosis can be accomplished through dietary nutrition alone (aka just eating food). You shouldn’t need a magic pill to do it. Just stay strict, remain vigilant, and be focused on recording what you eat (to make sure your carb and protein intake are correct).
Take a 2 – 3 cups of lettuce, crumble in some bacon and dice a medium tomato. Mix that with two or three tablespoons of mayo, and toss after adding some splashes of hot sauce. Delicious, filling, full of fiber and healthy fats, and absolutely easy. I know the mayo sounds weird as a dressing, but trust us; it’s amazing! Add in some avocado chunks to boost potassium too!
The beauty of salmon is that you can cook it with marginal interference. A simple sauce of butter, lemon juice, chopped garlic, and some salt and pepper will go a long way to enhancing the natural flavor of the salmon. Drizzle the sauce over 4-6 oz portions of fish, bake at 450F for 5 minutes per 1/2″ thickness of fish. In another bowl, toss the asparagus with olive oil, salt, and pepper, spread it out evenly on a cookie sheet, and roast in the oven at 450 for 20 minutes. Easy dinner (with leftovers if you plan ahead) that’s full of nutrition, protein, and healthy fat, while keeping your carbs low. Get the recipe and instructions
Keto for Cancer: Cancer is now being discussed as primarily a metabolic disease in which glucose can fuel its progression. Due to recent light shed on this subject, intensive investigations are underway and have begun to reveal that restricting carbohydrate intake can slow oncogenesis and that a full ketogenic-state may elicit even greater therapeutic benefits. Furthermore, research also suggests that fasting and the state of ketosis may increase the sensitivity of cancer cells to radiation and chemotherapy.
The most science-backed performance-boosting supplements, such as creatine monohydrate, beta-alanine, and caffeine, are all A-OK on the ketogenic diet. So, if you take a pre-workout, you should be able to continue without issue. I would also recommend gulping down some bouillon before your session to ensure your sodium and magnesium levels are on point.

When your body burns its stores of fat, it can be hard on your kidneys. And starting a ketogenic diet -- or going back to a normal diet afterward -- can be tricky if you’re obese because of other health issues you’re likely to have, like diabetes, a heart condition, or high blood pressure. If you have any of these conditions, make diet changes slowly and only with the guidance of your doctor.
When it comes to starting the keto diet (or any diet for that matter), there's one thing all experts agree on. You *must* have a plan. "Never try to wing a keto diet," says Julie Stefanski, R.D.N., C.S.S.D., L.D.N., a dietitian based in York, PA, who specializes in the ketogenic diet. "Set a start date and get prepared by reorganizing your pantry, planning out meal and snack options, and purchasing appropriate foods and dietary supplements," she says. "The biggest reason people have a hard time sticking with keto is that people don't have enough interesting foods to turn to, and high-carb favorites win out over good intention. If you didn't buy foods at the grocery store that fit the guidelines, there won't be an easy option in the fridge when you really need it." (A great place to start is this List of High-Fat Keto Foods Anyone Can Add to Their Diet.)
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Alcoholic ketoacidosis (AKA): AKA is a ketone-producing state that may occur following excessive alcohol consumption for long periods of time. When alcohol is metabolized in the liver, ketones are produced. Furthermore, as with other ketogenic states, certain biological changes, specifically at the hormonal level, occur to promote fat metabolism and ketone production. It is critical to note that AKA will not occur if the alcohol consumption is coupled with sugar.
Take a multivitamin. “Because you are removing grains, the majority of fruit, some vegetables, and a significant amount of dairy from your menu, a multivitamin is good insurance against any micronutrient deficiencies,” says Jadin. Depending on what your individual overall diet looks like, Jadin says you might also need to add a calcium, vitamin D, and potassium supplement.
Because some cancer cells are inefficient in processing ketone bodies for energy, the ketogenic diet has also been suggested as a treatment for cancer.[59][60] A 2018 review looked at the evidence from preclinical and clinical studies of ketogenic diets in cancer therapy. The clinical studies in humans are typically very small, with some providing weak evidence for anti-tumour effect, particularly for glioblastoma, but in other cancers and studies, no anti-tumour effect was seen. Taken together, results from preclinical studies, albeit sometimes contradictory, tend to support an anti-tumor effect rather than a pro-tumor effect of the KD for most solid cancers.[61]
If you're new to keto, watch out for hidden carbs. Generally, dairy products and nuts are a good way to meet your daily fat intake, but know that some of those items may contain more carbohydrates than you think. For example, yogurt topped with nuts may seem like a great keto-friendly snack, but a 5.3 ounce serving of plain yogurt has 12 grams of carbohydrates. Vanilla flavored yogurt has 24 grams of carbohydrates. Add an ounce of cashews, weighing in at nearly nine grams of carbs, and you’re up to 21 to 33 grams of carbs for that snack, which could knock you out of ketosis. Be sure to read nutrition labels carefully and pay careful attention to serving sizes. Track foods using a keto-specific app like Senza or KetoDiet can help you stay within your recommended daily carb intake.
One downside to a ketogenic diet for weight loss is the difficulty maintaining it. “Studies show that weight loss results from being on a low-carb diet for more than 12 months tend to be the same as being on a normal, healthy diet,” says Mattinson. While you may be eating more satiating fats (like peanut butter, regular butter, or avocado), you’re also way more limited in what’s allowed on the diet, which can make everyday situations, like eating dinner with family or going out with friends, far more difficult. Because people often find it tough to sustain, it’s easy to rely on it as a short-term diet rather than a long-term lifestyle.

In Asia, the normal diet includes rice and noodles as the main energy source, making their elimination difficult. Therefore, the MCT-oil form of the diet, which allows more carbohydrate, has proved useful. In India, religious beliefs commonly affect the diet: some patients are vegetarians, will not eat root vegetables or avoid beef. The Indian ketogenic diet is started without a fast due to cultural opposition towards fasting in children. The low-fat, high-carbohydrate nature of the normal Indian and Asian diet means that their ketogenic diets typically have a lower ketogenic ratio (1:1) than in America and Europe. However, they appear to be just as effective.[54]
Lastly, if you're active, you might need to make some adjustments to take that into account. "For the first one to two weeks, temporarily reducing your exercise load can be helpful as your body adjusts to being in ketosis," he says. "Additionally, for those who have an intense workout schedule, carb cycling may be a good option." Carb cycling essentially means you'll increase your carb intake on the days you're doing exercise, ideally just two to three days per week. "While low-carb days may be around 20 to 30 grams of net carbs daily, high-carb days can range all the way up to 100 grams, although it can vary based on your size and activity level," says Dr. Axe. (Related: 8 Things You Need to Know About Exercising on the Keto Diet.)
Everyone has to find their nutritional sweet spot for producing enough ketones and staying in ketosis, but “the core principle of the diet is to keep carbohydrate intake low enough, so your body continues producing ketones at elevated levels,” says Volek. “Your body adapts to this alternative fuel and becomes very efficient at breaking down and burning fat.”
Although you'll be cutting way back on carbohydrates and sugar, some fruits are still okay to eat on the keto diet (though you'll still want to be mindful about quantity in order to remain in ketosis). The fruits that make the cut contain far fewer carbs than their off-limits cousins such as apples, pears, bananas, pineapples, papayas, grapes, and fruit juices in general.

The best part of low carb eating is that you can still have rich, savory foods – dieting isn’t really a part of the lifestyle. Your body regulates your hunger naturally, so keeping your carbs low is the main concern. Being able to do that while still enjoying roast, fish, and big, healthy salads is what makes low carb so easy to stick with, and keep the weight off for good.

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The ketogenic diet may seem like the Jekyll to the Hyde-like low-fat craze of the 1990s. The bulk of current research finds that the middle ground between the two extremes is more beneficial for overall health. Make it easy for yourself: Eat at least two servings a week of fatty fish (salmon, sardines, mackerel) and cook with a variety of quality fats (olive oil, canola oil, avocado oil) throughout the week.
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